Ruskin Danielle A, Gagnon Michelle M, Kohut Sara A, Stinson Jennifer N, Walker Kathryn S
*The Hospital for Sick Children †Graduate Program in Psychology, York University ‡Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
Clin J Pain. 2017 Nov;33(11):1019-1029. doi: 10.1097/AJP.0000000000000490.
Pediatric chronic pain is a major health issue that can lead to significant interference in daily functioning. Mindfulness-based interventions (MBI's), which emphasize acceptance rather than control of pain, have gained increasing attention as a viable treatment option among adults with chronic pain. The effectiveness of MBIs for chronic pain in pediatric populations remains largely unknown. This prospective pre-post interventional study was conducted to examine the feasibility, acceptability, and initial effectiveness of an 8-week group MBI adapted for adolescents (MBI-A) with chronic pain.
Self-report measures assessing pain characteristics, anxiety, depression, disability, pain catastrophizing, perceived social support, mindfulness, and pain acceptance were administered at baseline, postintervention, and at a 3-month follow-up. In addition, session data were collected to assess each session's impact on patients' coping with pain and stress, body awareness, and sense of feeling less alone.
In total, 42 consecutive patients in a tertiary care chronic pain clinic met eligibility criteria to participate in the MBI-A group. Of these, 21 participated. A treatment completion rate of 90.5% was observed. Between session mindfulness practice was reported by 77% of participants. Participants were highly satisfied with the MBI-A and all participants reported they would recommend the group to a friend. Improvements in pain acceptance were observed between baseline and the 3-month follow-up, in domains of Pain Willingness and Activity Engagement. Session data revealed improved body awareness and improved ability to cope with stress across sessions.
The MBI-A is a feasible, well-received intervention for adolescents with chronic pain conditions. Findings support the need for further investigation of the efficacy of MBI-A through randomized-controlled trials.
儿童慢性疼痛是一个重大的健康问题,会对日常功能造成严重干扰。基于正念的干预措施(MBI)强调接纳而非控制疼痛,作为慢性疼痛成人患者可行的治疗选择,已越来越受到关注。MBI对儿童慢性疼痛的有效性在很大程度上仍不明确。本前瞻性干预前后研究旨在检验一种为慢性疼痛青少年(MBI-A)改编的为期8周的团体MBI的可行性、可接受性和初步有效性。
在基线、干预后和3个月随访时,采用自我报告测量方法评估疼痛特征、焦虑、抑郁、残疾、疼痛灾难化、感知社会支持、正念和疼痛接纳情况。此外,收集课程数据以评估每次课程对患者应对疼痛和压力、身体意识以及减少孤独感的影响。
一家三级护理慢性疼痛诊所共有42名连续患者符合参与MBI-A组的资格标准。其中,21名患者参与。观察到治疗完成率为90.5%。77%的参与者报告在课程之间进行了正念练习。参与者对MBI-A高度满意,所有参与者都表示会向朋友推荐该团体。在基线和3个月随访之间,在疼痛意愿和活动参与领域观察到疼痛接纳情况有所改善。课程数据显示,各课程之间身体意识有所改善,应对压力的能力有所提高。
MBI-A是一种对患有慢性疼痛的青少年可行且广受好评的干预措施。研究结果支持通过随机对照试验进一步研究MBI-A疗效的必要性。